Prospective observational analysis finds preperitoneal mesh reduces postoperative complications in umbilical hernias.
Background: Umbilical hernias-especially in women and patients with raised intra-abdominal pressure-pose a risk for postoperative seromas and infections. This study prospectively compares two mesh-based techniques: onlay versus preperitoneal placement. Methods: From January 2021 to December 2022, 50 adults with uncomplicated umbilical hernias were randomized to onlay (n=25) or preperitoneal (n=25) mesh repair. We monitored seroma formation, wound infection, flap necrosis, and length of hospital stay. Results: The onlay group experienced a 24% seroma rate and 24% wound-infection rate, plus one case of flap necrosis. The preperitoneal group had zero complications. Average hospital stay was 5.4 days in both arms. Conclusions: Preperitoneal mesh placement yields significantly fewer postoperative complications and should be the technique of choice for elective, uncomplicated umbilical hernia repair.
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Vaidya et al. (2025) studied this question.
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